Abstract
BackgroundSchools are key settings for delivering mental illness prevention in adolescents. Data on stakeholders’ attitudes and factors relevant for the implementation of Internet-based prevention programmes are scarce.MethodsStakeholders in the school setting from Austria and Spain were consulted. Potential facilitators (e.g. teachers and school psychologists) completed an online questionnaire (N=50), policy makers (e.g. representatives of the ministry of education and health professional associations) participated in semi-structured interviews (N=9) and pupils (N=29, 14–19 years) participated in focus groups. Thematic analysis was used to identify experiences with, attitudes and needs towards Internet-based prevention programmes, underserved groups, as well as barriers and facilitators for reach, adoption, implementation and maintenance.ResultsExperiences with Internet-based prevention programmes were low across all stakeholder groups. Better reach of the target groups was seen as main advantage whereas lack of personal contact, privacy concerns, risk for misuse and potential stigmatization when implemented during school hours were regarded as disadvantages. Relevant needs towards Internet-based programmes involved attributes of the development process, general requirements for safety and performance, presentation of content, media/tools and contact options of online programmes. Positive attitudes of school staff, low effort for schools and compatibility to schools’ curriculum were seen as key factors for successful adoption and implementation. A sound implementation of the programme in the school routine and continued improvement could facilitate maintenance of online prevention initiatives in schools.ConclusionsAttitudes towards Internet-based mental illness prevention programmes in school settings are positive across all stakeholder groups. However, especially safety concerns have to be considered.
Highlights
Effective and sustainable programmes for the prevention of mental health problems in adolescents are urgently needed as several European epidemiological studies revealed a high prevalence of mental health disorders and at-risk behaviours in this age group.[1,2,3] Schools are regarded as key settings for the implementation of prevention programmes as they offer unique access to a diverse population of adolescents in their familiar learning environment.[4]
According to the design of the ICare stakeholder survey described in Nitsch et al.[33] in this supplement, we consulted three different stakeholder groups in the school setting: (i) potential facilitators, (ii) policy makers (PM) and (iii) the target groups (TGs) of ICare interventions implemented in the school setting
This study provides useful insights into factors relevant for the design and sustainable implementation of Internet-based programmes for the prevention of mental health problems in school settings in Europe
Summary
Effective and sustainable programmes for the prevention of mental health problems in adolescents are urgently needed as several European epidemiological studies revealed a high prevalence of mental health disorders and at-risk behaviours in this age group.[1,2,3] Schools are regarded as key settings for the implementation of prevention programmes as they offer unique access to a diverse population of adolescents in their familiar learning environment.[4] The efficacy of school-based mental illness prevention programmes has been shown by numerous systematic reviews and meta-analyses including programmes targeted at the prevention of depression and anxiety,[5,6] substance abuse,[7] suicidality[8] and eating disorders.[9] Internet-based approaches like computer-based prevention programmes and smartphone applications (apps) are especially suitable for delivering mental health interventions to adolescents since young people are digital natives.[10] Two recently published meta-reviews[11,12] provide support for the effectiveness of Internet-based approaches for the prevention and early intervention of mental health problems across different mental health dimensions (attention-deficit hyperactivity disorder, autism, anxiety, depression, post-traumatic stress disorder, psychosis and eating disorders) for adolescents.
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